Waking Up in a Sweat? It Might Not Be Your Hormones

October 15, 2025

Night sweats are commonly associated with menopause, but anyone can experience them – at any age.

Waking up in a sweat can be a side effect of certain medications or even a normal part of some people’s circadian rhythm, but it can also be a sign of underlying illness, says Dana Habash-Bseiso, MD, an internal medicine specialist at University Hospitals. If night sweats are regularly disrupting your sleep, it’s important to tell your doctor.

What Are Night Sweats?

“Night sweats are recurring episodes of excessive sweating during sleep that can be strong enough to soak your pajamas and sheets, but aren't caused by another factor, like your bedroom being too warm,” says Dr. Habash-Bseiso.

“Night sweats are different from the normal fluctuations in body temperature that can occur during a regular circadian rhythm,” says Dr. Habash-Bseiso. These fluctuations can be triggered by a change in the temperature of your sleeping environment, sleeping with heavy blankets or thick pajamas, or exercising or eating spicy food around bedtime.

This type of sweating tends to be mild and doesn’t usually cause significant sleep interruptions, she says. It can typically be remedied by:

Keeping your bedroom cool.
Using lighter bedding in layers you can peel off at night.
Wearing loose-fitting pajamas made with breathable fabrics (like cotton or linen).
Avoiding physical activity, caffeine, alcohol, hot drinks, spicy foods and smoking cigarettes before bed.

Causes of Night Sweats

Night sweats affect many people, especially in midlife. Up to 41% of people, mostly in their 40s to mid-50s, experience night sweats—and about 80% of women get hot flashes and night sweats during the menopause transition.

Night sweats can be caused by:

Hormonal fluctuations and imbalances
Pregnancy
Medications (SSRIs, SNRIs, tricyclic antidepressants, opioids, antihypertensives)
Stress
Anxiety and panic disorders
Alcohol or substance use or misuse

Night sweats can also be caused by medical illnesses, such as:

Obesity
Hyperhidrosis (excessive sweating)
Infection (bacterial, viral or infectious diseases)
Endocrine conditions (like thyroid issues)
Sleep disorders (like sleep apnea)
Neurologic disorders (like stroke)
Digestive disease (like GERD)
Cancer (like leukemia or lymphoma)

When to Talk to Your Doctor

Sweating at night can be a normal response to various factors and conditions, including if you have a fever from a temporary illness. Dr. Habash-Bseiso advises alerting your doctor if you’re experiencing recurring night sweats that are accompanied by other symptoms, such as:

Persistent or periodic fevers
Generalized weakness
Extreme fatigue
Enlarged lymph nodes
Unexplained weight loss

“Middle-aged women may assume their symptoms are all related to hormone changes and menopause,” says Dr. Habash-Bseiso. “Yes, they could be, but they could also be signs of an illness, so it’s important to discuss them with your physician.”

How Your Doctor Determines What’s Causing Your Night Sweats

“Your doctor will need to put all of the pieces of the puzzle together,” says Dr. Habash-Bseiso. They’ll ask you questions about your symptoms and will likely want to do a physical exam.

For each symptom, be prepared to tell your doctor:

If it’s a new symptom.
How long you’ve had it.
How often you experience it.
How intense it is.
If it’s persistent.
If it’s mild, moderate or severe.
If it’s interrupting your sleep.
If it’s affecting your quality of life.

“We may also order diagnostic blood work to rule out infection, assess markers of inflammation, or measure hormone levels,” she says.

If you’re taking any medications that could be contributing to night sweats, your doctor may adjust it or the dosage levels. “But patients should not discontinue medication abruptly,” warns Dr. Habash-Bseiso. “It could worsen symptoms, especially if it’s a medication that needs to be tapered off, like hormonal, antidepressant or blood pressure medications."

Always be honest and forthcoming in your conversations with your doctor. “There are no silly questions,” says Dr. Habash-Bseiso. “It's so much better to discuss these things with your physician and be reassured, or at least figure out what’s going on.”

Each bit of information you provide can be a clue that helps your doctor—and ultimately helps you get better sleep. “In some cases,” adds Dr. Habash-Bseiso, “it could even save your life.”